Thapa Namisha, Ando Yumi, de Melo Silvio W
Department of Medicine, Oregon Health & Science University, Portland, OR.
Division of Gastroenterology and Hepatology, Oregon Health & Science University, Portland, OR.
ACG Case Rep J. 2019 Oct 25;6(10):e00264. doi: 10.14309/crj.0000000000000264. eCollection 2019 Oct.
Atrioesophageal fistula (AEF) is a rare complication of atrial fibrillation ablation. We present a man with sepsis and frank hematemesis 3 weeks after atrial fibrillation ablation. Thoracic computed tomography showed no definitive evidence of AEF. He underwent esophagogastroduodenoscopy and subsequently developed an embolic stroke. In the operating room, he was found to have AEF. This case highlights the importance of maintaining a high index of suspicion for AEF because of its nonspecific presentation and difficulty in diagnosing with imaging or endoscopy. Once AEF is suspected, esophagogastroduodenoscopy should be avoided because of the risk of precipitating embolic events.
心房食管瘘（AEF）是心房颤动消融术的一种罕见并发症。我们报告一名男性，在心房颤动消融术后3周出现败血症和明显的呕血。胸部计算机断层扫描未发现AEF的确切证据。他接受了食管胃十二指肠镜检查，随后发生了栓塞性中风。在手术室中，发现他患有AEF。该病例突出了对AEF保持高度怀疑指数的重要性，因为其表现不具特异性，且难以通过影像学或内镜检查进行诊断。一旦怀疑有AEF，应避免进行食管胃十二指肠镜检查，因为有引发栓塞事件的风险。
Zotero 插件